NC health insurance sign-ups on ACA market top half a million

Almost 560,000 North Carolinians bought or renewed health policies on the Affordable Care Act market by the time enrollment closed Sunday, the federal government announced Wednesday.

The total of 559,473 is a 56 percent increase over the number who signed up for 2014, the first year federally subsidized coverage was offered. South Carolina saw a 77 percent increase, to 209,773.

The Carolinas, like much of America, saw a surge of sign-ups in the final days of enrollment, perhaps spurred by a growing awareness of tax penalties for remaining uninsured.

“It was a blowout weekend for us,” said Kevin Counihan, CEO of the federal marketplace that serves the Carolinas and 35 other states.

National enrollment went from 6.7 million for 2014 to an estimated 11.4 million this year, up about 59 percent. Most who bought insurance through the ACA exchanges qualified for aid designed to help low- and moderate-income people afford coverage.

Proponents hailed enrollment growth as proof that the controversial health care act is working. The tallies come as “Obamacare” faces a barrage of political attacks and a Supreme Court challenge to the federal exchange. The national total topped the White House target by about 10 percent.

“Having health coverage means a lot to these people who are now covered. In our outreach efforts, we talked to many consumers who previously had not been able to afford coverage and had life-threatening ailments they left untreated,” said Sorien Schmidt of Get Covered North Carolina, a campaign to increase enrollment.

“It gives you some sense of how hungry people were out there for affordable, accessible health care,” President Barack Obama said in a video.

Critics say the initial numbers are likely to shrink – 2014 numbers went from 8 million to 6.7 million as the tallies were checked and people who chose plans failed to pay premiums. They also note that some who got ACA coverage already had insurance.

“Basically, the main people signing up for Obamacare exchange coverage are the ones who most heavily benefit from the law’s complex subsidy scheme: those with incomes near the poverty line, those with expensive diseases, and those nearing retirement. Most others are staying uninsured,” wrote Avik Roy, a Forbes opinion editor and critic of the ACA.

Counihan acknowledged that about 13 percent of those who sign up are expected to fall off the roster without paying. People may not follow through because they became eligible for workplace insurance, couldn’t afford the bill or changed their mind.

Joseph Piemont, president and chief operating officer at Carolinas HealthCare System, agrees that it’s difficult to tally exactly how many uninsured people got covered through the ACA. But, he said, “there is no doubt that there has been a net increase in the people we are seeing who are newly insured.”

Katherine Restrepo, health policy analyst for the conservative John Locke Foundation, said it’s a good thing to see more North Carolinians getting health coverage through the exchange. But she said more could benefit through elimination of the “many mandates and regulations” that come from the ACA, allowing companies to reduce their rates.

During the first year subsidized health insurance has been available, some residents of the Charlotte area have reported major benefits. Kimberly Tonyan, a Cornelius barber and single mother of twins, said being able to afford health insurance led her to an early cancer diagnosis and treatment for a rare genetic syndrome that could have taken her life.

Regina Thomas of Charlotte, unemployed after years of working in customer service, said insurance will help her get treatment for crippling back pain.

However, most agree that significant hurdles remain to providing affordable, cost-effective health care.

North and South Carolina, like other Republican-led states that refused federal money to expand Medicaid, continue to debate strategies for covering low-income adults who don’t qualify for subsidies.

Rising out-of-pocket costs pose a challenge for many who have insurance, including those who get workplace insurance and don’t qualify for subsidies.

North Carolina medical providers, including Carolinas HealthCare System, say they continue to cover costs for uninsured and underinsured people who can’t pay for care.

“We are seeing a fair amount of bad debt in North and South Carolina,” Piemont said, noting that states that expanded Medicaid have seen significant drops.